A national study of chronic disease prevalence and access to care in uninsured US adults
A national study of chronic disease prevalence and access to care in uninsured US adults
复制标题
DOI：
10.7326/0003-4819-149-3-200808050-00006
复制
发表时间：
2008-08-05
影响因子：
39.2
通讯作者：
Himmelstein, David U.
中科院分区：
文献类型：
--
作者：
Wilper, Andrew P.;Woolhandler, Steffie;Himmelstein, David U.
背景资料：没有最近的全国性研究评估慢性病患病率或获得护理的人没有保险在美国。S.设计：基于人群的调查，设置：国家健康和营养检查调查（1999 - 2004）。参与者：12486名年龄在18 - 64岁的患者。测量：心血管疾病、高血压、糖尿病、高胆固醇血症、活动性哮喘或慢性阻塞性肺病、既往癌症、以及获得护理的措施。根据全国健康与营养检查调查（1999-2004年）的答复，估计为1 140万份（95% CI，980万至1300万）患有慢性病的工作年龄美国人没有保险，其中16.1%在780万心血管疾病患者中，高血压患者占15.5%（CI，13.4%至17.6%），糖尿病患者占16.6%（CI，13.2%至20.0%）。在作者控制了年龄、性别、种族或民族之后，没有保险的慢性病患者比有保险的患者更有可能没有去看过健康专家（22.6% vs. 6.2%）和没有标准的护理场所（26.1% vs. 6.2%），但更有可能将其标准护理地点确定为急诊科（7.1% vs. 1.1%）（P
Background: No recent national studies have assessed chronic illness prevalence or access to care among persons without insurance in the United States.Objective: To compare reports of chronic conditions and access to care among U. S. adults, by self-reported insurance status.Design: Population-based survey.Setting: National Health and Nutritional Examination Survey (1999 2004).Participants: 12 486 patients age 18 to 64 years.Measurements: Estimates of national rates of cardiovascular disease, hypertension, diabetes, hypercholesterolemia, active asthma or chronic obstructive pulmonary disease, previous cancer, and measures of access to care.Results: On the basis of National Health and Nutrition Examination Survey (1999-2004) responses, an estimated 11.4 million (95% CI, 9.8 million to 13.0 million) working-age Americans with chronic conditions were uninsured, including 16.1% (CI, 12.6% to 19.6%) of the 7.8 million with cardiovascular disease, 15.5% (CI, 13.4% to 17.6%) of the 38.2 million with hypertension, and 16.6% (CI, 13.2% to 20.0%) of the 8.5 million with diabetes. After the authors controlled for age, sex, and race or ethnicity, chronically ill patients without insurance were more likely than those with coverage to have not visited a health professional (22.6% vs. 6.2%) and to not have a standard site for care (26.1% vs. 6.2%) but more likely to identify their standard site for care as an emergency department (7.1% vs. 1.1%) (P